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TCA 3 - Liver, Biliary and Pancreatic disease > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

What does Surface antigen (HBsAg) show?

A

An active infection

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2
Q

What does E antigen (HBeAg) show?

A

Marker of viral replication and implies high infectivity

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3
Q

What do core antibodies (HBcAB) show?

A

Implies past or current infection

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4
Q

What does surface antibody (HBsAb) show?

A

Implies vaccination or past or current infection

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5
Q

What does Hepatitis B virus DNA (HBV DNA) show?

A

This is a direct count of the viral load

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6
Q

What is an incubation period?

A

The time from the moment of exposure to an infectious agent until signs and symptoms of the disease appear

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7
Q

What does IgM indicate?

A

Acute infection

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8
Q

What does IgG indicate?

A

Previous infection or memory

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9
Q

What does the development of Hepatitis A look like?

A

Either recover (most common) or have fulminant hepatitis (1-2%)

  • Hepatitis A and E cause AcutE hepatitis
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10
Q

How is Hepatitis A spread?

A
  • Faeco-oral

- Shellfish

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11
Q

Where is Hepatitis A most prevalent?

A
  • Endemic in Africa and S America

Common in Children

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12
Q

What is the serology for Hepatitis A?

A
  • Hepatitis A viral RNA appears in stool after 1 week
  • Transaminases rise 22-40 days after exposure
  • IgM rises from day 25
  • IgG detectable for life
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13
Q

What is the preventative treatment for Hepatitis A?

A
  • Vaccination
    1st dose: 1yr immunity
    2nd dose: 20yr immunity
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14
Q

Can hepatitis A be treated?

A

Usually doesn’t need treatment as is self-limiting

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15
Q

What is the incubation period for Hepatitis A?

A

2-6 weeks

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16
Q

What determines progression of Hepatitis B to a chronic infection?

A 
- Age 
      <1 year 90% chronic
      1-5 years 30% chronic
      >5 years 1-5% chronic
- Immunosuppression
- Route of infection
- Genotype
17
Q

What does Hepatitis B have a strong association with?

A

Liver cancer

18
Q

How is Hepatitis B spread?

A
  • Vertical transmission from mother to child
  • Sexual
  • Blood
    IV drug users (IVDU), medical
  • Sharing contaminated household products
19
Q

What is the serology for an acute Hepatitis B infection?

A
  • Anti-core IgM
    Early rise
  • HBsAg
    Present for 1-6months
20
Q

What does anti-HBc imply?

A

Past infection

21
Q

What does anti-HBs alone imply?

A

Vaccination

22
Q

What is the preventative treatment for Hepatitis B?

A
  • Immunisation
    3 doses
    Immunise all sexual partners
23
Q

Can acute hepatitis B be treated?

A

Most people fully recover without treatment

24
Q

What is the serology for an chronic Hepatitis B infection?

A
  • HbsAg > 6 months

HBeAg +ve = high viral load, infection, normal LFTs, few liver problems

HBeAb +ve = low viral load, raised transaminases, liver fibrosis and cirrhosis

25
Q

Can chronic hepatitis B be treated?

A
  • Antivirals
  • Interferons
    Give to HBeAg +ve
26
Q

What is the incubation period for hepatitis B?

A

1-6 months

27
Q

What does the development of Hepatitis C look like?

A
  • 25% Recover

- 75% Chronic hepatitis

28
Q

How is Hepatitis C spread?

A
  • Blood
  • Sexual
  • Vertical
29
Q

What is the serology for an acute Hepatitis C infection?

A
  • Anti-HCV
  • HVC-PCR
    RNA -ve
    Have been exposed to, but now cleared the virus
30
Q

Can chronic hepatitis C be treated?

A
  • Inferferon
    Ribavirin
  • Protease inhibitors

Can be re-infected after treatment

31
Q

What does the development of Hepatitis E look like?

A

Same as hepatitis A

32
Q

How is Hepatitis E spread?

A
  • Faecal-oral route

- Undercooked pork, wild boar and deer

33
Q

When may Hepatitis E cause severe disease?

A

2nd trimester of pregnancy

34
Q

What is the serology for a Hepatitis E infection?

A
  • HEV IgM = active infection

- HEV IgG = recovery

35
Q

What does the development of Hepatitis Delta look like?

A
  • Requires co-infection with Hepatitis B

- Worsens prognosis of Hepatitis B

36
Q

What is the serology for a Hepatitis Delta infection?

A
  • Anti-HDV antibody

Only ask if HBsAg +ve

TCA 3 - Liver, Biliary and Pancreatic disease (6 decks)

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